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Paediatric 'care closer to home': stake-holder views and barriers to implementation

Gemma Heath1, Elaine Cameron, Carole Cummins

  • 1School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. g.heath@bham.ac.uk

Health & Place
|June 13, 2012
PubMed

Insights

NHS stakeholders support paediatric care closer to home (CCTH) in community clinics. However, they question its practical implementation due to challenges in setting up and maintaining these services.

Area of Science:

  • Healthcare Management
  • Paediatric Healthcare Delivery
  • Health Services Research

Background:

  • The UK National Health Service (NHS) is exploring models for delivering paediatric care closer to home (CCTH).
  • This involves shifting specialist outpatient services from hospitals to community-based clinics.
  • Stakeholder perspectives are crucial for understanding the feasibility and impact of such initiatives.

Purpose of the Study:

  • To explore the views of NHS stakeholders regarding the provision of paediatric care closer to home (CCTH).
  • To identify facilitators and barriers to implementing CCTH models in community settings.
  • To understand how CCTH impacts professional practice and service delivery.

Main Methods:

  • Semi-structured interviews were conducted with key NHS stakeholders.
  • Thematic framework analysis was employed to analyze the interview data.
  • Participants included healthcare professionals, managers, commissioners, and executive team members.

Main Results:

  • Stakeholders recognized CCTH as a positive principle for paediatric outpatient services.
  • They acknowledged that CCTH requires changes in traditional working practices and clinic settings.
  • Challenges in establishing and sustaining community clinics led to skepticism about widespread CCTH implementation.

Conclusions:

  • The location of healthcare delivery is intrinsically linked to professional identity and practice.
  • Successful policy implementation requires consideration of place, power dynamics, and professional identity.
  • Initiatives that overlook these factors may face significant obstacles in achieving their goals.
Abstract

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